Michigan State University in conjunction with the Michigan Department of Community Health and the Michigan Department of Licensing and Regulatory Affairs has been conducting state-based occupational injury and illness surveillance since 1988. This proposal will continue and expand this activity. This proposal will fund activity to generate the occupational indicators and surveillance programs for four specific conditions: (1) occupational lung disease; (2) acute work-related pesticide illness; (3) work-related acute traumatic non-fatal injuries; and 4) work-related acute traumatic fatalities. The state has had NIOSH funded projects in work-related asthma from 1988 to date, pesticides from 2001 to date, silicosis from 1988-1992 and 2002 to date, acute traumatic fatalities from 2002 to date and occupational lung disease from 2010 to date. Since initiation of surveillance, cases of work-related asthma, cases of acute pesticide poisoning, cases of silicosis, and acute traumatic fatalities have been confirmed. Follow-back industrial hygiene inspections have been conducted, and fellow workers interviewed during these inspections. The confirmation process, industrial hygiene inspections and fellow worker interviews will be continued. There has been 100% reporting from the 136 acute care hospitals in the state. A quarterly newsletter (total of 148 different newsletters) and annual reports have been written and mailed out to approximately 3,300 targeted physicians and health care professionals. The above active outreach to encourage reporting will be continued as well as presentations and display booths at medical meetings, publishing papers in the medical literature, via our website, Twitter, Facebook, the NIOSH Science Blog, and working with other state organizations, such as the medical licensing board, to publicize Michigan's occupational disease reporting law. Evaluation of the effectiveness of our effort to improve working conditions will also continue. In addition to the above basic surveillance we will be expanding our outreach, follow back and evaluation activity. New activity planned includes: expanding surveillance to include nonfatal traumatic injuries, projects on under-reporting, evaluation of OSHA inspections for following up reported cases and projects on special populations and industrial sectors.